CN112168392A - Dental navigation surgery registration method and system - Google Patents

Dental navigation surgery registration method and system Download PDF

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Publication number
CN112168392A
CN112168392A CN202011129874.9A CN202011129874A CN112168392A CN 112168392 A CN112168392 A CN 112168392A CN 202011129874 A CN202011129874 A CN 202011129874A CN 112168392 A CN112168392 A CN 112168392A
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Prior art keywords
groove
coordinate system
tip
navigation instrument
visual navigation
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王利峰
沈晨
刘洪澎
孙贝
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Yake Wisdom Beijing Technology Co ltd
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Yake Wisdom Beijing Technology Co ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0089—Implanting tools or instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0089—Implanting tools or instruments
    • A61C8/009—Implanting tools or instruments for selecting the right implanting element, e.g. templates
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00—Image analysis
    • G06T7/30—Determination of transform parameters for the alignment of images, i.e. image registration
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00—Image analysis
    • G06T7/70—Determining position or orientation of objects or cameras
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10004—Still image; Photographic image
    • G06T2207/10012—Stereo images
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10072—Tomographic images
    • G06T2207/10081—Computed x-ray tomography [CT]
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/30—Subject of image; Context of image processing
    • G06T2207/30004—Biomedical image processing
    • G06T2207/30008—Bone
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/30—Subject of image; Context of image processing
    • G06T2207/30004—Biomedical image processing
    • G06T2207/30036—Dental; Teeth

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Physics & Mathematics (AREA)
  • General Physics & Mathematics (AREA)
  • Theoretical Computer Science (AREA)
  • Dental Prosthetics (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Abstract

The embodiment of the invention provides a dental navigation surgery registration method and system, wherein an artificial mark point is arranged on a jaw bone of a patient in a non-invasive mode, the artificial mark point arranged on the jaw bone of the patient is clicked by a probe or a drill bit of a visual navigation instrument according to the special structure of the artificial mark point, the coordinate of the tip of a groove in the artificial mark point in a coordinate system of the visual navigation instrument is determined, the coordinate of the tip of the groove in the artificial mark point in a CT image space coordinate system is determined at the same time, then the corresponding relation of the two coordinate systems is registered according to the coordinates of the tip of the groove in the artificial mark point in the two coordinate systems, and the mapping relation between a virtual space coordinate system and the visual navigation instrument coordinate system is obtained to finish the registration of the oral implantation navigation surgery.

Description

Dental navigation surgery registration method and system
Technical Field
The invention relates to the technical field of oral medical treatment, in particular to a dental navigation surgery registration method and system.
Background
Many factors in daily life cause tooth loss, and dental implants are becoming a popular method of repairing lost teeth as opposed to fixed and removable dentures. The accuracy of the position and angle of implant implantation is a key factor affecting the success or failure of dental surgery.
The registration is a key step in the oral implant navigation operation, namely, the relative position posture relation between the virtual space coordinate system and the visual navigation instrument coordinate system is determined. At present, a mark point registration method is often adopted to realize the registration, that is, a mapping relation between a mark point on a medical image and a corresponding mark point on a human body is established to establish a mapping relation between two spaces. The mark points can be jaw bone or tooth anatomical mark points, and also can be artificial mark points with smaller volume. The registration with the anatomical landmark points is less accurate and depends on the operation experience of the doctor, while the registration with the artificial landmark points usually needs to be implanted into the alveolar process or jaw bone of the patient, which may cause unnecessary trauma and even infection to the patient.
Disclosure of Invention
Aiming at the problems in the prior art, the embodiment of the invention provides a dental navigation surgery registration method and system.
Specifically, the embodiment of the invention provides the following technical scheme:
in a first aspect, an embodiment of the present invention provides a dental navigation surgery registration method, including:
arranging an artificial marking point on a jaw bone of a patient in a non-invasive mode, wherein the artificial marking point is basically in a cuboid shape, a groove is formed in the top surface of the cuboid, and the shape of the groove is matched with the tip part of a probe of a visual navigation instrument or a drill bit of a mobile phone implant, so that the tip part of the probe of the visual navigation instrument or the drill bit of the mobile phone implant is tightly inserted into the groove, a fixed contact relation can be formed between the tip part of the probe of the visual navigation instrument or the drill bit of the mobile phone implant and the groove, and the position of the tip of the groove in a coordinate system of the visual navigation instrument can be detected by the probe or the mobile phone implant;
determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system;
selecting an artificial marking point arranged on the jaw bone of the patient by using a probe of the visual navigation instrument or a drill bit of the implanting mobile phone, and determining the coordinate of the tip of a groove in the artificial marking point in a coordinate system of the visual navigation instrument;
determining a space conversion relation between a CT image space coordinate system and a visual navigation instrument coordinate system according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system;
and mapping the coordinates of the implanting mobile phone in the coordinate system of the visual navigation instrument to the space coordinate system of the CT image in the operation process according to the space conversion relation so as to convert the actual position of the implanting mobile phone acquired by the visual navigation instrument into the CT virtual image for displaying, and guiding the actual operation through the CT virtual image to realize accurate operation navigation.
Further, determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system comprises:
and fusing the oral cavity scanning data and the oral cavity CT data in a registration mode, and determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system.
Further, fusing the oral cavity scanning data and the oral cavity CT data together in a registration mode, and determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system, wherein the coordinates comprise:
carrying out oral cavity scanning on the oral cavity of the patient by using an oral cavity scanner to obtain a three-dimensional curved surface of the oral cavity of the patient, wherein the three-dimensional curved surface data comprises the jaw bone of the patient and the artificial mark points;
carrying out CT scanning on the oral cavity of the patient by using a CT scanner to obtain jaw bone data of the patient;
according to the determined corresponding relation between the jaw data of the patient obtained by CT scanning and the three-dimensional curved surface data of the jaw of the patient obtained by oral scanning, matching the jaw data of the patient obtained by two different modes through a registration algorithm;
and after matching is finished, determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system according to the matching relation.
Further, after the matching is completed, determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system according to the matching relation, wherein the coordinates comprise:
and after matching is finished, clicking the tip point of the groove in the CT virtual image by using a mouse, and acquiring the coordinate of the tip point in a CT image space coordinate system.
Further, after the matching is completed, determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system according to the matching relation, wherein the coordinates comprise:
after matching is finished, adopting a standard groove to fit the groove corresponding to the artificial marking point in the CT virtual image according to the shape and size parameters of the groove corresponding to the artificial marking point, and adopting the coordinate of the tip point of the standard groove in the space coordinate system of the CT image as the coordinate of the tip of the groove in the artificial marking point in the space coordinate system of the CT image;
and the shape and the size parameters of the standard groove are consistent with those of the groove corresponding to the artificial marking point.
Further, the method for determining the coordinates of the tip of the groove in the artificial mark point in the coordinate system of the visual navigation instrument by using the probe of the visual navigation instrument or the drill of the mobile phone includes:
calibrating the relative position relationship between the visual mark on the probe or the planting mobile phone of the visual navigation instrument and the probe or the planting mobile phone in advance;
and determining the coordinates of the tip of the groove in the artificial mark point arranged on the jaw bone of the patient, which is clicked by the probe or the drill bit of the visual navigation instrument, in the coordinate system of the visual navigation instrument according to the relative position relationship calibrated in advance between the visual mark on the probe or the implanting mobile phone of the visual navigation instrument and the probe or the implanting mobile phone.
Further, determining a spatial transformation relationship between the CT image space coordinate system and the visual navigation instrument coordinate system according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system, including:
and calculating the optimal transformation of the two coordinate systems by adopting a singular value decomposition method according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system so as to determine the space transformation relation between the CT image space coordinate system and the visual navigation instrument coordinate system.
Further, adopt the non-invasive mode to set up artificial mark point on patient's jaw, include:
the artificial mark points are adhered to the surface of the teeth of the patient through special dental glue, and the grooves are exposed outwards, so that a probe or a drill bit for implanting a mobile phone can be used for point selection.
Further, the groove is one or more of a conical groove, a hemispherical groove or a cylindrical groove.
In a second aspect, an embodiment of the present invention further provides a dental navigation surgery registration system, including:
the device comprises a setting module, a measuring module and a control module, wherein the setting module is used for setting an artificial mark point on a jaw bone of a patient in a noninvasive mode, the basic shape of the artificial mark point is a cuboid, a groove is formed in the top surface of the cuboid, the shape of the groove is matched with the tip part of a probe of a visual navigation instrument or a drill bit of a mobile phone implant, so that the tip part of the probe of the visual navigation instrument or the drill bit of the mobile phone implant is tightly inserted into the groove, the tip part of the probe of the visual navigation instrument or the drill bit of the mobile phone implant can form a fixed contact relation with the groove, and the position of the tip of the groove in a coordinate system of the visual navigation instrument can be detected by the probe or the mobile phone implant;
the first determining module is used for determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system;
the second determination module is used for clicking artificial mark points arranged on the jaw bone of the patient by using a probe of the visual navigation instrument or a drill bit of the implanting mobile phone, and determining the coordinates of the tips of the grooves in the artificial mark points in a coordinate system of the visual navigation instrument;
the third determining module is used for determining the space conversion relation between the CT image space coordinate system and the visual navigation instrument coordinate system according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system;
and the registration module is used for mapping the coordinates of the implanting mobile phone in the coordinate system of the visual navigation instrument to the space coordinate system of the CT image in the operation process according to the space conversion relation so as to convert the actual position of the implanting mobile phone acquired by the visual navigation instrument into the CT virtual image for displaying, and guiding the actual operation through the CT virtual image to realize accurate operation navigation.
According to the technical scheme, the dental navigation surgery registration method and system provided by the embodiment of the invention have the advantages that the artificial mark points are arranged on the jaw bone of the patient in a non-invasive mode, the basic shape of the artificial mark points is cuboid, the top surface of the cuboid is provided with the groove, the shape of the groove is matched with the tip part of the probe of the visual navigation instrument or the drill bit of the implanting mobile phone, so that the tip part of the probe of the visual navigation instrument or the drill bit of the implanting mobile phone is tightly inserted into the groove, the tip part of the probe of the visual navigation instrument or the drill bit of the implanting mobile phone can form a fixed contact relation with the groove, the position of the tip of the groove in the coordinate system of the visual navigation instrument can be detected by the probe or the implanting mobile phone, and then the coordinates of the tip of the groove in the space coordinate system of the CT image are determined, selecting an artificial mark point arranged on the jaw bone of the patient by using a probe of the visual navigation instrument or a drill bit of the implanting mobile phone, determining the coordinate of the tip of a groove in the artificial mark point in a coordinate system of the visual navigation instrument, then determining the space conversion relation between a space coordinate system of the CT image and the coordinate system of the visual navigation instrument according to the coordinate of the tip of the groove in the artificial mark point in the coordinate system of the CT image and the coordinate system of the artificial mark point in the coordinate system of the visual navigation instrument, and finally mapping the coordinate of the implanting mobile phone in the coordinate system of the visual navigation instrument to the space coordinate system of the CT image according to the space conversion relation in the operation process so as to convert the actual position of the implanting mobile phone acquired by the visual navigation instrument into a CT virtual image for display, the actual operation is guided through the CT virtual image, and accurate operation navigation is realized. Therefore, the embodiment of the invention sets the artificial mark point on the jaw bone of the patient in a non-invasive manner, and selects the artificial mark point set on the jaw bone of the patient by using the probe of the visual navigation instrument or the drill of the implanting mobile phone according to the special structure of the artificial mark point, determines the coordinate of the tip of the groove in the artificial mark point in the coordinate system of the visual navigation instrument, and simultaneously determines the coordinate of the tip of the groove in the artificial mark point in the space coordinate system of the CT image, and then registers the corresponding relation of the two coordinate systems according to the coordinates of the tip of the groove in the artificial mark point in the two coordinate systems, and finally obtains the mapping relation between the virtual space coordinate system (namely the space coordinate system of the CT image for performing the navigation operation) and the coordinate system of the visual navigation instrument, thereby completing the registration of the oral implantation navigation operation.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and those skilled in the art can also obtain other drawings according to the drawings without creative efforts.
Fig. 1 is a flowchart of a dental navigation surgery registration method according to an embodiment of the present invention;
FIG. 2 is a schematic structural diagram of an artificial mark point according to an embodiment of the present invention;
fig. 3 is a schematic view illustrating an implementation process of a dental navigation surgery registration method according to an embodiment of the present invention;
fig. 4 is a schematic structural diagram of a dental navigation surgery registration system according to an embodiment of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Fig. 1 shows a flowchart of a dental navigation surgery registration method provided by an embodiment of the present invention. As shown in fig. 1, a dental navigation surgery registration method provided by an embodiment of the present invention includes the following steps:
step 101: arranging an artificial marking point on a jaw bone of a patient in a non-invasive mode, wherein the artificial marking point is basically in a cuboid shape, a groove is formed in the top surface of the cuboid, and the shape of the groove is matched with the tip part of a probe of a visual navigation instrument or a drill bit of a mobile phone implant, so that the tip part of the probe of the visual navigation instrument or the drill bit of the mobile phone implant is tightly inserted into the groove, a fixed contact relation can be formed between the tip part of the probe of the visual navigation instrument or the drill bit of the mobile phone implant and the groove, and the position of the tip of the groove in a coordinate system of the visual navigation instrument can be detected by the probe or the mobile phone implant;
step 102: determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system;
step 103: selecting an artificial marking point arranged on the jaw bone of the patient by using a probe of the visual navigation instrument or a drill bit of the implanting mobile phone, and determining the coordinate of the tip of a groove in the artificial marking point in a coordinate system of the visual navigation instrument;
step 104: determining a space conversion relation between a CT image space coordinate system and a visual navigation instrument coordinate system according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system;
step 105: and mapping the coordinates of the implanting mobile phone in the coordinate system of the visual navigation instrument to the space coordinate system of the CT image in the operation process according to the space conversion relation so as to convert the actual position of the implanting mobile phone acquired by the visual navigation instrument into the CT virtual image for displaying, and guiding the actual operation through the CT virtual image to realize accurate operation navigation.
In this embodiment, it should be noted that an object of this embodiment is to provide a registration method for dental navigation surgery, which sets artificial mark points on a jaw bone of a patient in a non-invasive manner, and performs registration according to a corresponding relationship between medical image data, so as to obtain a mapping relationship between a virtual space coordinate system (i.e., a CT image space coordinate system for performing a navigation surgery) and a visual coordinate system (also referred to as a visual navigation instrument coordinate system), and further complete registration of an oral implant navigation surgery.
In the present embodiment, it is understood that the navigation operation is usually performed in a virtual space of CT data of a patient, and the position and posture of the patient and the surgical instrument are captured simultaneously by using an optical navigation instrument and displayed in the virtual space of a CT image. The doctor can guide the actual operation according to the virtual image on the display equipment, for example, the doctor can accurately complete the operation by avoiding important anatomical positions (nerves, blood vessels and the like) according to the feedback on the virtual image.
The present embodiment uses a non-invasive method to set artificial markers on the jaw bone of a patient, and the series of markers can link the CT coordinate space with the actual visual space.
As shown in fig. 2, the basic shape of the artificial marker may be designed as a rectangular parallelepiped, and preferably may be a cube, and a groove is formed on a top surface of the cube, such as a tapered groove (as shown in fig. 2), the shape of the tapered groove is consistent with a probe of a visual navigation instrument (for detecting a position of a tip of the probe in a coordinate system of the visual navigation instrument) or a tip of a specific drill of the implanting handpiece (it should be noted that, the shape of the groove is not limited, and may also be a hemispherical shape or a cylindrical shape, as long as a fixed contact relationship can be formed with a tip point of the probe), and the tip of the drill of the probe or the implanting handpiece may be tightly inserted into the tapered groove. I.e. the position of the tip of the conical indentation in the visual navigation instrument coordinate system, can be detected by a probe or an implantation handset (see fig. 2). The artificial mark point can be quickly manufactured by 3D printing or the like, and can be manufactured in a standardized manner.
In this embodiment, the coordinates of the tip of the groove in the artificial marker point in the CT image space coordinate system can be determined from the oral CT image.
In this embodiment, it should be noted that the probe or the implanting mobile phone of the visual navigation instrument is used to click the artificial mark point pasted on the jaw bone of the patient to connect the two coordinate systems.
It can be understood that the probe and the implanting handset of the visual navigation instrument are usually fixed with a visual marker (as shown in fig. 3), and a sensor of the visual navigation instrument can capture the position and the posture of the visual marker in real time, so that the position coordinate of the drill bit of the probe or the implanting handset can be indirectly calculated. After calibration (i.e. the relative position relationship between the visual marker and the probe or the implanting mobile phone is determined in advance), the probe and the implanting mobile phone can touch any point in the visual field range of the visual navigation instrument by using the tip of the probe and the implanting mobile phone, and the coordinate of the contact point in the visual coordinate system is obtained.
Specifically, in the embodiment, the probe or the implanting mobile phone can be used for acquiring the coordinate V of the conical groove tip point of the artificial mark point in the visual coordinate system1、V2、…、VnN is the number of marked points, and the coordinate of the point in the corresponding CT coordinate system is C1、C2、…、Cn. The two groups of corresponding data points can be subjected to optimal transformation calculation by adopting a Singular Value Decomposition (SVD) method to obtain a spatial transformation relation between two point sets, namely a point set { V }1,V2,...,VnAnd { C }1,C2,...,CnAnd registering, and matching the images together through rotation and translation, namely finally solving a rotation matrix R and translation vector t to minimize the transformed error.
In this embodiment, it can be understood that, after the spatial transformation relationship between the two corresponding point sets is calculated, the coordinates in the visual coordinate system may be mapped into the coordinate system of the CT virtual image, that is, the actual position acquired by the visual navigation instrument may be converted into the CT virtual image for display, and the CT virtual image is used to guide the actual surgical operation, thereby implementing accurate surgical navigation.
As can be seen from the above technical solutions, in the dental navigation surgery registration method provided in the embodiments of the present invention, an artificial mark point is non-invasively disposed on a jaw bone of a patient, the artificial mark point has a rectangular parallelepiped basic shape, a groove is disposed on a top surface of the rectangular parallelepiped, and the shape of the groove matches with a tip of a drill of a visual navigation instrument or a implanting handpiece, so that a tip of the drill of the visual navigation instrument or the implanting handpiece is tightly inserted into the groove, and the tip of the drill of the visual navigation instrument or the implanting handpiece can form a fixed contact relationship with the groove, so that a position of the tip of the groove in a coordinate system of the visual navigation instrument can be detected by the probe or the implanting handpiece, and then a coordinate of the tip of the groove in the artificial mark point in a CT image space coordinate system is determined, selecting an artificial mark point arranged on the jaw bone of the patient by using a probe of the visual navigation instrument or a drill bit of the implanting mobile phone, determining the coordinate of the tip of a groove in the artificial mark point in a coordinate system of the visual navigation instrument, then determining the space conversion relation between a space coordinate system of the CT image and the coordinate system of the visual navigation instrument according to the coordinate of the tip of the groove in the artificial mark point in the coordinate system of the CT image and the coordinate system of the artificial mark point in the coordinate system of the visual navigation instrument, and finally mapping the coordinate of the implanting mobile phone in the coordinate system of the visual navigation instrument to the space coordinate system of the CT image according to the space conversion relation in the operation process so as to convert the actual position of the implanting mobile phone acquired by the visual navigation instrument into a CT virtual image for display, the actual operation is guided through the CT virtual image, and accurate operation navigation is realized. Therefore, the embodiment of the invention sets the artificial mark point on the jaw bone of the patient in a non-invasive manner, and selects the artificial mark point set on the jaw bone of the patient by using the probe of the visual navigation instrument or the drill of the implanting mobile phone according to the special structure of the artificial mark point, determines the coordinate of the tip of the groove in the artificial mark point in the coordinate system of the visual navigation instrument, and simultaneously determines the coordinate of the tip of the groove in the artificial mark point in the space coordinate system of the CT image, and then registers the corresponding relation of the two coordinate systems according to the coordinates of the tip of the groove in the artificial mark point in the two coordinate systems, and finally obtains the mapping relation between the virtual space coordinate system (namely the space coordinate system of the CT image for performing the navigation operation) and the coordinate system of the visual navigation instrument, thereby completing the registration of the oral implantation navigation operation.
Based on the content of the above embodiment, in this embodiment, determining the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system includes:
and fusing the oral cavity scanning data and the oral cavity CT data in a registration mode, and determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system.
In this embodiment, it should be noted that, in order to accurately obtain the position of the artificial marker point in the CT space and avoid the influence of factors such as CT image artifacts (images that do not belong to the scanned object due to the device or the patient), the embodiment fuses the oral cavity scan data and the CT data together in a registration manner, so as to accurately obtain the position of the artificial marker point in the CT image space.
Based on the content of the above embodiment, in the present embodiment, fusing the oral scan data and the oral CT data together in a registration manner, and determining the coordinates of the tip of the groove in the artificial marker point in the CT image space coordinate system, includes:
carrying out oral cavity scanning on the oral cavity of the patient by using an oral cavity scanner to obtain a three-dimensional curved surface of the oral cavity of the patient, wherein the three-dimensional curved surface data comprises the jaw bone of the patient and the artificial mark points;
carrying out CT scanning on the oral cavity of the patient by using a CT scanner to obtain jaw bone data of the patient;
according to the determined corresponding relation between the jaw data of the patient obtained by CT scanning and the three-dimensional curved surface data of the jaw of the patient obtained by oral scanning, matching the jaw data of the patient obtained by two different modes through a registration algorithm;
and after matching is finished, determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system according to the matching relation.
In this embodiment, it should be noted that, in order to accurately obtain the position of the artificial marker point in the CT space and avoid the influence of factors such as CT image artifacts (images that do not belong to the scanned object due to the device or the patient), the embodiment fuses the oral cavity scan data and the CT data together in a registration manner, so as to accurately obtain the position of the artificial marker point in the CT image space, and the specific processing procedure may include the following steps:
A. the artificial mark points are adhered to the surface of the teeth of the patient through special dental glue, the tooth surface which is easy to adhere can be selected at the specific adhering position, and the conical grooves are exposed outwards, so that the subsequent point selection can be conveniently carried out by using a probe or a mobile implant.
B. After the artificial mark points are pasted, the oral cavity of the patient is scanned in the mouth, namely an intraoral scanner is used for obtaining a three-dimensional curved surface of the oral cavity of the patient, and the three-dimensional curved surface data comprises the jaw bone of the patient and the pasted artificial mark points.
C. Because the jaw bone three-dimensional curved surface data of the patient obtained by oral cavity scanning and the jaw bone data obtained by CT scanning have clear corresponding relation, the two jaw bone data of the patient obtained by different modes can be matched together by a registration algorithm, such as an iterative closest point algorithm (ICP algorithm).
D. And after matching is finished, the coordinates of the tip point of the conical groove can be obtained in the CT coordinate space. Specifically, in one implementation, the tip point of the conical groove can be clicked in the CT space by a mouse, and the coordinates of the tip point in the CT image coordinate system can be obtained. In another implementation, if the tip point of the groove is difficult to select in the CT space due to the problems such as the accuracy of generating the curved surface by the oral cavity scanning instrument, a standard cone (because the size parameter of the cone groove is known when designing the artificial mark point) may be used to fit the cone groove, and the tip point of the standard cone is used as the coordinate of the artificial mark point in the CT image space, so that the coordinate of the tip point of the cone groove may be obtained more accurately in the CT coordinate space.
Based on the content of the above embodiment, in this embodiment, after the matching is completed, determining coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system according to the matching relationship includes:
and after matching is finished, clicking the tip point of the groove in the CT virtual image by using a mouse, and acquiring the coordinate of the tip point in a CT image space coordinate system.
In this embodiment, it should be noted that after the matching is completed, the coordinates of the groove tip point can be obtained in the CT coordinate space. In the implementation manner of this embodiment, the tip point of the notch can be clicked in the CT space (i.e., in the CT virtual image) with a mouse, and the coordinates of the point in the CT image coordinate system can be obtained.
Based on the content of the above embodiment, in this embodiment, after the matching is completed, determining coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system according to the matching relationship includes:
in this embodiment, it should be noted that after the matching is completed, the coordinates of the groove tip point can be obtained in the CT coordinate space. It can be understood that sometimes the problem of the accuracy of the curved surface generated by the oral cavity scanning instrument, etc., causes the groove tip point to be difficult to select in the CT space, at this time, a standard groove (because the size parameter of the groove is known when designing the artificial mark point) can be used to fit the real groove, and the tip point of the standard groove is used as the coordinate of the artificial mark point in the CT image space, so that the coordinate of the groove tip point can be more accurately obtained in the CT coordinate space.
In this embodiment, it will be appreciated that for a tapered recess, the point is the tapered recess point. For a cylindrical recess, the point is the cylindrical recess point, and so on.
Based on the content of the above embodiment, in this embodiment, clicking an artificial mark point disposed on the jaw bone of the patient by using a probe of the visual navigation instrument or a drill of the mobile phone, and determining coordinates of a tip of a groove in the artificial mark point in a coordinate system of the visual navigation instrument includes:
calibrating the relative position relationship between the visual mark on the probe or the planting mobile phone of the visual navigation instrument and the probe or the planting mobile phone in advance;
and determining the coordinates of the tip of the groove in the artificial mark point arranged on the jaw bone of the patient, which is clicked by the probe or the drill bit of the visual navigation instrument, in the coordinate system of the visual navigation instrument according to the relative position relationship calibrated in advance between the visual mark on the probe or the implanting mobile phone of the visual navigation instrument and the probe or the implanting mobile phone.
In this embodiment, it can be understood that, the probe and the implant handset of the visual navigation instrument are usually fixed with a visual marker (as shown in fig. 3), and the sensor of the visual navigation instrument can capture the position and the posture of the visual marker in real time, so that the position coordinate of the drill bit of the probe or the implant handset can be indirectly calculated. After calibration (i.e. the relative position relationship between the visual marker and the probe or the implanting mobile phone is determined in advance), the probe and the implanting mobile phone can touch any point in the visual field range of the visual navigation instrument by using the tip of the probe and the implanting mobile phone, and the coordinate of the contact point in the visual coordinate system is obtained.
Based on the content of the foregoing embodiment, in this embodiment, determining the spatial transformation relationship between the CT image space coordinate system and the visual navigation instrument coordinate system according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system includes:
and calculating the optimal transformation of the two coordinate systems by adopting a singular value decomposition method according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system so as to determine the space transformation relation between the CT image space coordinate system and the visual navigation instrument coordinate system.
In this embodiment, the probe or the implanting mobile phone can be used to obtain the coordinate V of the tip point of the conical groove of the artificial mark point in the visual coordinate system1、V2、…、VnN is the number of marked points, and the coordinate of the point in the corresponding CT coordinate system is C1、C2、…、Cn. The two groups of corresponding data points can be subjected to optimal transformation calculation by adopting a Singular Value Decomposition (SVD) method to obtain a spatial transformation relation between two point sets, namely a point set { V }1,V2,...,VnAnd { C }1,C2,...,CnAnd registering, and matching the images together through rotation and translation, namely finally solving a rotation matrix R and translation vector t to minimize the transformed error.
In this embodiment, it can be understood that, after the spatial transformation relationship between the two corresponding point sets is calculated, the coordinates in the visual coordinate system may be mapped into the coordinate system of the CT virtual image, that is, the actual position acquired by the visual navigation instrument may be converted into the CT virtual image for display, and the CT virtual image is used to guide the actual surgical operation, thereby implementing accurate surgical navigation.
Based on the content of the above embodiments, in the present embodiment, the non-invasive method is used to set the artificial mark points on the jaw bone of the patient, including:
the artificial mark points are adhered to the surface of the teeth of the patient through special dental glue, and the grooves are exposed outwards, so that a probe or a drill bit for implanting a mobile phone can be used for point selection.
Based on the content of the above embodiments, in the present embodiment, the groove is one or more of a conical groove, a hemispherical groove, or a cylindrical groove, which is not limited in the present embodiment.
Fig. 4 shows a schematic structural diagram of a dental navigation surgery registration system provided by an embodiment of the present invention. As shown in fig. 4, the present embodiment provides a dental navigation surgery registration system, including: a setting module 21, a first determining module 22, a second determining module 23, a third determining module 24 and a registration module 25, wherein:
the setting module 21 is configured to set an artificial mark point on a jaw bone of a patient in a non-invasive manner, the artificial mark point is a cuboid, a groove is formed in a top surface of the cuboid, and the shape of the groove is matched with a tip part of a probe of a visual navigation instrument or a drill of a mobile phone implant, so that the tip part of the probe of the visual navigation instrument or the drill of the mobile phone implant is tightly inserted into the groove, and the tip part of the probe of the visual navigation instrument or the drill of the mobile phone implant can form a fixed contact relationship with the groove, and further the position of the tip of the groove in a coordinate system of the visual navigation instrument can be detected by the probe or the mobile phone implant;
the first determining module 22 is used for determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system;
the second determining module 23 is configured to select an artificial mark point arranged on the jaw bone of the patient by using a probe of the visual navigation instrument or a drill of the implanting mobile phone, and determine a coordinate of a tip of a groove in the artificial mark point in a coordinate system of the visual navigation instrument;
a third determining module 24, configured to determine a spatial transformation relationship between the CT image space coordinate system and the visual navigation instrument coordinate system according to coordinates of a tip of the groove in the artificial mark point in the CT image space coordinate system and coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system;
and the registration module 25 is configured to map the coordinates of the implant handset in the coordinate system of the visual navigation instrument to the spatial coordinate system of the CT image in the surgical procedure according to the spatial transformation relationship, so as to transform the actual position of the implant handset acquired by the visual navigation instrument to a CT virtual image for display, guide the actual surgical operation through the CT virtual image, and implement accurate surgical navigation.
Based on the content of the foregoing embodiment, in this embodiment, the first determining module 22 is specifically configured to:
and fusing the oral cavity scanning data and the oral cavity CT data in a registration mode, and determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system.
Based on the content of the foregoing embodiment, in this embodiment, the first determining module 22 is specifically configured to:
carrying out oral cavity scanning on the oral cavity of the patient by using an oral cavity scanner to obtain a three-dimensional curved surface of the oral cavity of the patient, wherein the three-dimensional curved surface data comprises the jaw bone of the patient and the artificial mark points;
carrying out CT scanning on the oral cavity of the patient by using a CT scanner to obtain jaw bone data of the patient;
according to the determined corresponding relation between the jaw data of the patient obtained by CT scanning and the three-dimensional curved surface data of the jaw of the patient obtained by oral scanning, matching the jaw data of the patient obtained by two different modes through a registration algorithm;
and after matching is finished, determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system according to the matching relation.
Based on the content of the foregoing embodiment, in this embodiment, when the step of determining the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system according to the matching relationship after the matching is performed by the first determining module 22 is specifically configured to:
and after matching is finished, clicking the tip point of the groove in the CT virtual image by using a mouse, and acquiring the coordinate of the tip point in a CT image space coordinate system.
Based on the content of the foregoing embodiment, in this embodiment, when the step of determining the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system according to the matching relationship after the matching is performed by the first determining module 22 is specifically configured to:
after matching is finished, adopting a standard groove to fit the groove corresponding to the artificial marking point in the CT virtual image according to the shape and size parameters of the groove corresponding to the artificial marking point, and adopting the coordinate of the tip point of the standard groove in the space coordinate system of the CT image as the coordinate of the tip of the groove in the artificial marking point in the space coordinate system of the CT image;
and the shape and the size parameters of the standard groove are consistent with those of the groove corresponding to the artificial marking point.
Based on the content of the foregoing embodiment, in this embodiment, the second determining module 23 is specifically configured to:
calibrating the relative position relationship between the visual mark on the probe or the planting mobile phone of the visual navigation instrument and the probe or the planting mobile phone in advance;
and determining the coordinates of the tip of the groove in the artificial mark point arranged on the jaw bone of the patient, which is clicked by the probe or the drill bit of the visual navigation instrument, in the coordinate system of the visual navigation instrument according to the relative position relationship calibrated in advance between the visual mark on the probe or the implanting mobile phone of the visual navigation instrument and the probe or the implanting mobile phone.
Based on the content of the foregoing embodiment, in this embodiment, the third determining module 24 is specifically configured to:
and calculating the optimal transformation of the two coordinate systems by adopting a singular value decomposition method according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system so as to determine the space transformation relation between the CT image space coordinate system and the visual navigation instrument coordinate system.
Based on the content of the foregoing embodiment, in this embodiment, the setting module 21 is specifically configured to:
the artificial mark points are adhered to the surface of the teeth of the patient through special dental glue, and the grooves are exposed outwards, so that a probe or a drill bit for implanting a mobile phone can be used for point selection.
Based on the content of the above embodiments, in the present embodiment, the groove is one or more of a conical groove, a hemispherical groove, or a cylindrical groove.
The above-described embodiments of the apparatus are merely illustrative, and the units described as separate parts may or may not be physically separate, and parts displayed as units may or may not be physical units, may be located in one place, or may be distributed on a plurality of network units. Some or all of the modules may be selected according to actual needs to achieve the purpose of the solution of the embodiment of the present invention. One of ordinary skill in the art can understand and implement it without inventive effort.
Through the above description of the embodiments, those skilled in the art will clearly understand that each embodiment can be implemented by software plus a necessary general hardware platform, and certainly can also be implemented by hardware. Based on such understanding, the above technical solutions may be embodied in the form of a software product, which may be stored in a computer-readable storage medium, such as ROM/RAM, a magnetic disk, an optical disk, etc., and includes several instructions for enabling a computer device (which may be a personal computer, a server, or a network device, etc.) to execute the dental navigation surgery registration method according to various embodiments or some portions of embodiments.
Moreover, in the present invention, relational terms such as first and second, and the like may be used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Also, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising an … …" does not exclude the presence of other identical elements in a process, method, article, or apparatus that comprises the element.
Furthermore, in the present disclosure, reference to the description of the terms "one embodiment," "some embodiments," "an example," "a specific example," or "some examples" or the like means that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the present disclosure. In this specification, the schematic representations of the terms used above are not necessarily intended to refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, various embodiments or examples and features of different embodiments or examples described in this specification can be combined and combined by one skilled in the art without contradiction.
Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.

Claims (10)

1. A dental navigated surgery registration method, comprising:
arranging an artificial marking point on a jaw bone of a patient in a non-invasive mode, wherein the artificial marking point is basically in a cuboid shape, a groove is formed in the top surface of the cuboid, and the shape of the groove is matched with the tip part of a probe of a visual navigation instrument or a drill bit of a mobile phone implant, so that the tip part of the probe of the visual navigation instrument or the drill bit of the mobile phone implant is tightly inserted into the groove, a fixed contact relation can be formed between the tip part of the probe of the visual navigation instrument or the drill bit of the mobile phone implant and the groove, and the position of the tip of the groove in a coordinate system of the visual navigation instrument can be detected by the probe or the mobile phone implant;
determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system;
selecting an artificial marking point arranged on the jaw bone of the patient by using a probe of the visual navigation instrument or a drill bit of the implanting mobile phone, and determining the coordinate of the tip of a groove in the artificial marking point in a coordinate system of the visual navigation instrument;
determining a space conversion relation between a CT image space coordinate system and a visual navigation instrument coordinate system according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system;
and mapping the coordinates of the implanting mobile phone in the coordinate system of the visual navigation instrument to the space coordinate system of the CT image in the operation process according to the space conversion relation so as to convert the actual position of the implanting mobile phone acquired by the visual navigation instrument into the CT virtual image for displaying, and guiding the actual operation through the CT virtual image to realize accurate operation navigation.
2. The dental pilot procedure registration method of claim 1, wherein determining coordinates of a tip of a groove in the artificial marker point in a CT image space coordinate system comprises:
and fusing the oral cavity scanning data and the oral cavity CT data in a registration mode, and determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system.
3. The dental navigation surgery registration method according to claim 2, wherein fusing the oral scan data with the oral CT data in registration, determining coordinates of the tip of the groove in the artificial marker point in a CT image space coordinate system comprises:
carrying out oral cavity scanning on the oral cavity of the patient by using an oral cavity scanner to obtain a three-dimensional curved surface of the oral cavity of the patient, wherein the three-dimensional curved surface data comprises the jaw bone of the patient and the artificial mark points;
carrying out CT scanning on the oral cavity of the patient by using a CT scanner to obtain jaw bone data of the patient;
according to the determined corresponding relation between the jaw data of the patient obtained by CT scanning and the three-dimensional curved surface data of the jaw of the patient obtained by oral scanning, matching the jaw data of the patient obtained by two different modes through a registration algorithm;
and after matching is finished, determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system according to the matching relation.
4. The dental navigation surgery registration method according to claim 3, wherein determining coordinates of a tip of a groove in the artificial mark point in a CT image space coordinate system according to a matching relationship after matching is completed comprises:
and after matching is finished, clicking the tip point of the groove in the CT virtual image by using a mouse, and acquiring the coordinate of the tip point in a CT image space coordinate system.
5. The dental navigation surgery registration method according to claim 3, wherein determining coordinates of a tip of a groove in the artificial mark point in a CT image space coordinate system according to a matching relationship after matching is completed comprises:
after matching is finished, adopting a standard groove to fit the groove corresponding to the artificial marking point in the CT virtual image according to the shape and size parameters of the groove corresponding to the artificial marking point, and adopting the coordinate of the tip point of the standard groove in the space coordinate system of the CT image as the coordinate of the tip of the groove in the artificial marking point in the space coordinate system of the CT image;
and the shape and the size parameters of the standard groove are consistent with those of the groove corresponding to the artificial marking point.
6. The dental navigation surgery registration method according to claim 1, wherein the artificial mark points provided on the jaw bone of the patient are clicked by a probe or a drill of an implanting handpiece of the visual navigation instrument, and the coordinates of the tips of the grooves in the artificial mark points in a visual navigation instrument coordinate system are determined, including:
calibrating the relative position relationship between the visual mark on the probe or the planting mobile phone of the visual navigation instrument and the probe or the planting mobile phone in advance;
and determining the coordinates of the tip of the groove in the artificial mark point arranged on the jaw bone of the patient, which is clicked by the probe or the drill bit of the visual navigation instrument, in the coordinate system of the visual navigation instrument according to the relative position relationship calibrated in advance between the visual mark on the probe or the implanting mobile phone of the visual navigation instrument and the probe or the implanting mobile phone.
7. The dental navigation surgery registration method according to claim 1, wherein determining the spatial transformation relationship of the CT image space coordinate system and the visual navigation instrument coordinate system according to the coordinates of the tip of the groove in the artificial marking point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial marking point in the visual navigation instrument coordinate system comprises:
and calculating the optimal transformation of the two coordinate systems by adopting a singular value decomposition method according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system so as to determine the space transformation relation between the CT image space coordinate system and the visual navigation instrument coordinate system.
8. The dental navigation surgery registration method according to claim 1, wherein the non-invasive method is used for setting artificial mark points on the jaw bone of the patient, and comprises the following steps:
the artificial mark points are adhered to the surface of the teeth of the patient through special dental glue, and the grooves are exposed outwards, so that a probe or a drill bit for implanting a mobile phone can be used for point selection.
9. The dental pilot surgery registration method of claim 1, wherein the groove is one or more of a conical groove, a hemispherical groove, or a cylindrical groove.
10. A dental navigated surgical registration system, comprising:
the device comprises a setting module, a measuring module and a control module, wherein the setting module is used for setting an artificial mark point on a jaw bone of a patient in a noninvasive mode, the basic shape of the artificial mark point is a cuboid, a groove is formed in the top surface of the cuboid, the shape of the groove is matched with the tip part of a probe of a visual navigation instrument or a drill bit of a mobile phone implant, so that the tip part of the probe of the visual navigation instrument or the drill bit of the mobile phone implant is tightly inserted into the groove, the tip part of the probe of the visual navigation instrument or the drill bit of the mobile phone implant can form a fixed contact relation with the groove, and the position of the tip of the groove in a coordinate system of the visual navigation instrument can be detected by the probe or the mobile phone implant;
the first determining module is used for determining the coordinates of the tip of the groove in the artificial mark point in a CT image space coordinate system;
the second determination module is used for clicking artificial mark points arranged on the jaw bone of the patient by using a probe of the visual navigation instrument or a drill bit of the implanting mobile phone, and determining the coordinates of the tips of the grooves in the artificial mark points in a coordinate system of the visual navigation instrument;
the third determining module is used for determining the space conversion relation between the CT image space coordinate system and the visual navigation instrument coordinate system according to the coordinates of the tip of the groove in the artificial mark point in the CT image space coordinate system and the coordinates of the tip of the groove in the artificial mark point in the visual navigation instrument coordinate system;
and the registration module is used for mapping the coordinates of the implanting mobile phone in the coordinate system of the visual navigation instrument to the space coordinate system of the CT image in the operation process according to the space conversion relation so as to convert the actual position of the implanting mobile phone acquired by the visual navigation instrument into the CT virtual image for displaying, and guiding the actual operation through the CT virtual image to realize accurate operation navigation.
CN202011129874.9A 2020-10-21 2020-10-21 Dental navigation surgery registration method and system Pending CN112168392A (en)

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CN116785001B (en) * 2023-08-25 2023-10-31 深圳卡尔文科技有限公司 Method, system and storage medium for calibrating implantation operation tool

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